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目的观察新辅助治疗用于治疗低位进展期直肠癌临床疗效及意义。方法 32例进展期低位直肠癌患者,给予新辅助治疗,采用FOLFOX6方案化疗2个周期,放疗方案采用2 Gy/d,每周照射5 d,持续5周,照射总剂量为50 Gy,化疗结束4~6周进行手术治疗,观察临床治疗效果。结果经治疗后,肿瘤TNM分期出现不同程度的下降,肿瘤距肛缘的距离由平均(5.10±1.4)cm增加至(6.45±1.6)cm,差异有统计学意义(P<0.05);肿块体积均不同程度缩小,平均最长径由(4.6±1.4)cm缩小至(2.8±1.2)cm,差异有统计学意义(P<0.05);血清CEA值化疗前(46.5±17.2)ng/ml降至化疗后(21.4±11.2)ng/ml,差异有统计学意义(P<0.05)。27例患者接受Dixon手术,5例患者接受Miles手术,手术保肛率达84.38%。结论术前实施新辅助治疗是一种治疗低位进展期直肠癌有效方法,可以达到降低肿瘤分期、提高保肛率、降低肿瘤局部复发的目的 ,随着新化疗药物的研发及新辅助治疗方案的提出,对于直肠癌治疗将取得进一步的效果。
Objective To observe the clinical effect and significance of neoadjuvant therapy in the treatment of low-grade advanced rectal cancer. Methods Thirty-two patients with advanced low rectal cancer undergoing neoadjuvant chemotherapy were enrolled. Two cycles of FOLFOX6 regimen were used. The radiotherapy regimen was 2 Gy / d for 5 days per week for 5 weeks. The total radiation dose was 50 Gy. 4 to 6 weeks for surgical treatment, observation of clinical treatment. Results The TNM staging of the tumors decreased to some extent after treatment. The distance from the anal verge increased from 5.10 ± 1.4 cm to 6.45 ± 1.6 cm, the difference was statistically significant (P <0.05) (4.6 ± 1.4) cm decreased to (2.8 ± 1.2) cm, the difference was statistically significant (P <0.05); serum CEA value before chemotherapy (46.5 ± 17.2) ng / ml After chemotherapy (21.4 ± 11.2) ng / ml, the difference was statistically significant (P <0.05). 27 patients underwent Dixon surgery and 5 patients underwent Miles surgery. The anus preservation rate reached 84.38%. Conclusions The implementation of neoadjuvant therapy preoperatively is an effective method for the treatment of low-grade advanced rectal cancer, which can reduce the tumor staging, improve the anal sphincter rate and reduce the local recurrence of tumor. With the development of new chemotherapy drugs and neoadjuvant treatment Proposed that for the treatment of rectal cancer will achieve further results.